Automatic analysis of speech F0 contour for the characterization of mood changes in bipolar patients

da inserireBipolar disorders are characterized by a mood swing, ranging from mania to depression. A system that could monitor and eventually predict these changes would be useful to improve therapy and avoid dangerous events. Speech might convey relevant information about subjects' mood and there is a growing interest to study its changes in presence of mood disorders. In this work we present an automatic method to characterize fundamental frequency (F0) dynamics in voiced part of syllables. The method performs a segmentation of voiced sounds from running speech samples and estimates two categories of features. The first category is borrowed from Taylor's Tilt intonational model. However, the meaning of the proposed features is different from the meaning of Taylor's ones since the former are estimated from all voiced segments without performing any analysis of intonation. A second category of features takes into account the speed of change of F0. In this work, the proposed features are first estimated from an emotional speech database. Then, an analysis on speech samples acquired from eleven psychiatric patients experiencing different mood states, and eighteen healthy control subjects is introduced. Subjects had to perform a text reading task and a picture commenting task. The results of the analysis on the emotional speech database indicate that the proposed features can discriminate between high and low arousal emotions. This was verified both at single subject and group level. An intra-subject analysis was performed on bipolar patients and it highlighted significant changes of the features with different mood states, although this was not observed for all the subjects. The directions of the changes estimated for different patients experiencing the same mood swing, were not coherent and were task-dependent. Interestingly, a single-subject analysis performed on healthy controls and on bipolar patients recorded twice with the same mood label, resulted in a very small number of significant differences. In particular a very good specificity was highlighted for the Taylor-inspired features and for a subset of the second category of features, thus strengthening the significance of the results obtained with patients. Even if the number of enrolled patients is small, this work suggests that the proposed features might give a relevant contribution to the demanding research field of speech-based mood classifiers. Moreover, the results here presented indicate that a model of speech changes in bipolar patients might be subject-specific and that a richer characterization of subject status could be necessary to explain the observed variability

Experience of the use of Ketamine to manage opioid withdrawal in an addicted woman: a case report.

BACKGROUND: Opioids are good painkillers, but many patients treated with opioids as painkillers developed a secondary addiction. These patients need to stop misusing opioids, but the mild-to-severe clinical symptoms associated with opioid withdrawal risk increasing their existing pain. In such cases, ketamine, which is used by anaesthetists and pain physicians to reduce opioid medication, may be an effective agent for managing opioid withdrawal. CASE PRESENTATION: We describe the case of a woman who developed a severe secondary addiction to opioids in the context of lombo-sciatic pain. She presented a severe opioid addiction, and her physicians refused to prescribe such high doses of opioid treatment (oxycontin® extended-release 120 mg daily, oxycodone 60 mg daily, and acetaminophen/codeine 300 mg/25 mg 6 times per day). To assist her with her opioid withdrawal which risked increasing her existing pain, she received 1 mg/kg ketamine oral solution, and two days after ketamine initiation her opioid treatment was gradually reduced. The patient dramatically reduced the dosage of opioid painkillers and ketamine was withdrawn without any withdrawal symptoms. CONCLUSION: Ketamine displays many interesting qualities for dealing with all symptoms relating to opioid withdrawal. Accordingly, it could be used instead of many psychotropic treatments, which interact with each other, to help with opioid withdrawal. However, the literature describes addiction to ketamine. All in all, although potentially addictive, ketamine could be a good candidate for the pharmacological management of opioid withdrawal.case reportsjournal article2016 Nov 102016 11 10importe

HCV Coinfection Associated with Slower Disease Progression in HIV-Infected Former Plasma Donors Naïve to ART

It remains controversial how HCV coinfection influences the disease progression during HIV-1 infection. This study aims to define the influence of HCV infection on the replication of HIV-1 and the disease progression in HIV-infected former plasma donors (FPDs) naïve to ART.168 HIV-1-infected FPDs were enrolled into a cohort study from Anhui province in central China, and thereafter monitored at month 3, 9, 15, 21 and 33. Fresh whole blood samples were used for CD4+ T-cell counting. Their plasma samples were collected and stored for quantification of HIV-1 viral loads and for determination of HCV and Toxoplasma. Out of 168 HIV-infected FBDs, 11.9% (20 cases), 80.4% (135 cases) and 7.7% (13 cases) were infected with HIV-1 alone, HIV-1/HCV and HIV/HCV/Toxoplasma, respectively. During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/µl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05). CD4+ T cells in HIV mono infection group were consistently lower than that in HIV/HCV group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04).These data indicated HCV coinfection with HIV-1 is associated with the slower disease progression at the very late stage when comparing with HIV-1 mono-infection. The coinfection of Toxoplasma with HIV and HCV did not exert additional influence on the disease progression. It will be highly interesting to further explore the underlying mechanism for this observation in the future

Immuno-metabolic profile of patients with psychotic disorders and metabolic syndrome. Results from the FACE-SZ cohort

Background: Metabolic syndrome (MetS) is a highly prevalent and harmful medical disorder often comorbid with psychosis where it can contribute to cardiovascular complications. As immune dysfunction is a key shared component of both MetS and schizophrenia (SZ), this study investigated the relationship between immune alterations and MetS in patients with SZ, whilst controlling the impact of confounding clinical characteristics including psychiatric symptoms and comorbidities, history of childhood maltreatment and psychotropic treatments. Method: A total of 310 patients meeting DSM-IV criteria for SZ or schizoaffective disorders (SZA), with or without MetS, were systematically assessed and included in the FondaMental Advanced Centers of Expertise for Schizophrenia (FACE-SZ) cohort. Detailed clinical characteristics of patients, including psychotic symptomatology, psychiatric comorbidities and history of childhood maltreatment were recorded and the serum levels of 18 cytokines were measured. A penalized regression method was performed to analyze associations between inflammation and MetS, whilst controlling for confounding factors. Results: Of the total sample, 25% of patients had MetS. Eight cytokines were above the lower limit of detection (LLOD) in more than 90% of the samples and retained in downstream analysis. Using a conservative Variable Inclusion Probability (VIP) of 75%, we found that elevated levels of interleukin (IL)-6, IL-7, IL-12/23 p40 and IL-16 and lower levels of tumor necrosis factor (TNF)-α were associated with MetS. As for clinical variables, age, sex, body mass index (BMI), diagnosis of SZ (not SZA), age at the first episode of psychosis (FEP), alcohol abuse, current tobacco smoking, and treatment with antidepressants and anxiolytics were all associated with MetS. Conclusion: We have identified five cytokines associated with MetS in SZ suggesting that patients with psychotic disorders and MetS are characterized by a specific “immuno-metabolic” profile. This may help to design tailored treatments for this subgroup of patients with both psychotic disorders and MetS, taking one more step towards precision medicine in psychiatry. © 2022 The AuthorsImmuno-Génétique, Inflammation, retro-Virus, Environnement : de l'étiopathogénie des troubles psychotiques aux modèles animauxRéseau d'Innovation sur les Voies de Signalisation en Sciences de la Vi

Improving reproductive health care services for women with a physical disability: Insights from a community survey of women with spinal cord injury in Switzerland

Objective: To describe a cohort of women with a physical disability in various reproductive life stages to support the development of specific management targets, especially during the fertile stage. Design: Community survey. Population / Sample: We analysed data from 440 female participants with chronic spinal cord injury (SCI) aged over 16 years from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI) in 2017. Methods: The full cohort was analysed using descriptive analysis. For women in the fertile reproductive life stage, a regression technique was used to identify the predictors of becoming a mother after SCI. Results: More than 50% of the sample were aged over 56, and approximately one fourth were in the fertile (16-45 years) age group. Motherhood after SCI was most prevalent in women with low and incomplete lesions and those who sustained an SCI at a young age. The chances of giving birth significantly decreased when sustaining an SCI after the age of 35. The mean age at first delivery after SCI (age 31.2±5 years) was five years higher compared to women with an SCI who gave birth before sustaining SCI (age 26.2±5 years). Conclusions: The study provides evidence for the need for tailored and specific lifespan adjusted obstetric and gynaecological services for women with SCI and for women with a disability in general

PISA et la transition vers le marché du travail

Dieser Beitrag untersucht den Einfluss der PISA-Lesekompetenzen am Ende der obligatorischen Schulzeit auf einen erfolgreichen Arbeitsmarkteintritt. Die deskriptiven Ergebnisse zeigen, dass Jugendliche mit tiefen PISA-Messwerten ein signifikant erhöhtes Risiko aufweisen, zwei Jahre nach Berufsbildungsabschluss inadäquat beschaftigt zu sein. Weiter gehende Analysen verdeutlichen hingegen, dass es der Typ beruflicher Grundbildung ist, welcher for eine erfolgreiche Arbeitsmarkttransition entscheidend ist. Nichtsdestotrotz haben PISA-Scores einen indirekten Einfluss auf den Übergang ins Erwerbsleben, da sie ein wichtiger Erklarungsfaktor dafür sind, wer Zugang zu Berufsbildungsgängen mit hohen Anforderungen bekommt.Cette contribution examine l'influence des compétences de lecture PISA en fin de scolarité obligatoire sur la manière dont les jeunes négocient leur entrée sur le marché du travail. Les résultats descriptifi montrent que les jeunes qui ont de mauvais résultats PISA, présentent un risque nettement plus élevé de se retrouver deux ans après l'obtention du diplôme de formation professionnelle dans un emploi inadéquat. Une analyse plus approfondie montre cependant que la réussite est étroitement liée au type de formation professionnelle de base. Malgré cela, les résultats PISA ont une influence indirecte sur le passage à la vie professionnelle, dans la mesure où ils expliquent qui a accès aux parcours de formation professionnelle à exigences élevées

What happened to the PISA 2000 participants five years later?

The transition from school-to-work has been a burning issue in most countries for the last decades. So far research on this topic has not been conclusive, and it is still not clear whether transition problems are just individual, linked to the type of education followed at uppersecondary level or just a prolongation of problems arising from poor school performance during compulsory education. This paper uses a unique Swiss longitudinal data-set, which includes information on PISA 2000 scores and the pathways chosen after completing compulsory school. Descriptive results show that students in vocational training, who obtained lower PISA results, are signicantly more likely to be in an inadequate employment situation two years after nishing vocational training. Further analysis shows, however, that it is the type of vocational training followed at upper-secondary level that is decisive for the success in the transition. Nevertheless, individual PISA scores have an indirect impact on the transition results, as they are an important factor explaining which pupils are more likely to get into an intellectually demanding vocational training and which ones are not

Selective immunocytochemical localisation of calretinin in the human ovary1

Calretinin is a calcium-binding protein which is primarily expressed by certain cells of the nervous system, both central and peripheral. Its presence in nonexcitable cells has been little studied. Using a polyclonal antibody and paraffin sections we have analysed the presence of calretinin in the human ovary of different ages, and in polycystic ovaries. Our results revealed the selective presence of calretinin, specifically localised in the cells of the germinal epithelium, those of the theca interna and the theca lutein cells, in the cells of the neurovaso-epithelial association and of the canalicular structures of the mesovarium. Calretinin was also present in a few cells of the theca externa and some interstitial cells. No appreciable quantitative differences in the strength of the positive reaction were seen between the ovaries of different ages or between the normal and the polycystic ovaries. The presence of calretinin was confirmed by western blot analysis. The selective presence of calretinin in the human ovary, in androgenic cells and in the cells of the germinal epithelium is discussed in relation to its possible function as a Ca2+ buffe